title: Purulent pericarditis and cardiac tamponade caused by Nocardia farcinica in a nephrotic syndrome patient.
abstract: Nocardiosis is an uncommon infection that occurs primarily in immunocompromised patients. We herein report an extremely rare case of Nocardia farcinica (N. farcinica) pericarditis. A 53-year-old man with nephrotic syndrome that required chronic corticosteroid therapy presented with pleuritic chest pain and cardiac tamponade. Pericardiocentesis revealed purulent pericardial effusion and a bacteriological examination showed the characteristic branching filamentous bacteria identified as N. farcinica. Aggressive surgical drainage and a trimethoprim-sulfamethoxazole based regimen resulted in clinical improvement. To the best of our knowledge, this is the first reported case of N. farcinica pericarditis in Thailand.
authors.affiliation: Department of Internal Medicine, Siriraj Hospital Faculty of Medicine, Mahidol University, Thailand.
authors.forename: Rujipas
authors.initials: R
authors.lastname: Sirijatuphat
authors.forename: Sorachat
authors.initials: S
authors.lastname: Niltwat
authors.forename: Orathai
authors.initials: O
authors.lastname: Tiangtam
authors.forename: Wiwun
authors.initials: W
authors.lastname: Tungsubutra
mesh_terms: D002305:Cardiac Tamponade / Q000175:diagnosis* / Q000209:etiology / Q000382:microbiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009404:Nephrotic Syndrome / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology; D009615:Nocardia / Q000302:isolation & purification; D009617:Nocardia Infections / Q000150:complications / Q000175:diagnosis*; D010493:Pericarditis / Q000175:diagnosis* / Q000209:etiology / Q000382:microbiology